I’ve Had 10 Diagnoses, Got This Disorder For Life

A teenager Bex’s despair at our mental health system . Twice she has been refused Hospital admission when suicidal. ( Radio 4 today full transcript on Newsbeat ‘Me and My Mind’ available on i-player.  Jeremy Hunt Health Secretary responded ‘only had Crisis Teams 3 years ..it takes time, help isn’t happening everywhere’, he might have added nor does it look like happening anytime soon.

Bex complains that she has OCD, repeatedly checks windows etc, her thoughts sometimes make her too fearful to leave home ‘all thoughts going over, no off switch, tight, chest. It is extremely unlikely that she actually has 10 disorders, but as comorbidity is the norm doubtless she has a couple of disorders. It is inecusable that these  disorders have not be reliably identified and treatment pathways for each illuminated. Making treatment available doubtless requires increased funding but just as importantly the monitoring of fidelity to evidence based treatment protocols for the identified disorders.

I’d like to think of Bex’s case as exceptional, but she reminds me of a former client of mine who unquestionably had a primary diagnoses of borderline personality disorder (BPD). I discovered yesterday that she dropped out of treatment at the behest of a drug taking boyfriend. Since she has done the rounds of local mental health services who have labelled her as having bipolar disorder and she is taking Lithium and having therapy in secondary care. To her family’s dismay she continues to create chaos, her mum has to look after her baby etc. Once again a failure to address the key problem.


Dr Mike Scott

2 thoughts to “I’ve Had 10 Diagnoses, Got This Disorder For Life”

  1. Unfortunately this seems to me to be a common theme in secondary care, where the norm is to accumulate as many diagnoses as possible , which of course will stay with that individual for life. Psychology & psychotherapists may as well be speaking different languages in the so called MDT , where it seems to me the culture is at best dominated by a kind of ‘folk psychology’, which fails the patient completely .For years now secondary care services have been modelled by the least psychologically minded of all professionals that is the Nurse Managers who assume they don’t need any background in psychology or psychotherapy to understand the needs of patients.

  2. Hi Charlie
    Absolutely agree, just talking to a mental health practitioner in secondary care, his team is dominated by the psychiatrist who declared we are 80% about medication and 20% about talking therapies! He has very little scope to offer cbt and little power to direct therapy. He witnessed an 18 year old walking out of the consultation with the psychiatrist because of the insistence she take her anti-psychotic medication. but this medication had been of little or no value over 8 years. The MHP is fearful that trying to discuss the content of the client’s paranoia with her will be seen as collusion!.


    Mike Scott

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